But health officials and doctors have not
effectively communicated the message. Little HIV
prevention education is targeted at older people.
Most older people do not receive training in safer
sexual activities. Because older people don’t see
themselves on posters or billboards advertising AIDS
prevention, they may think they are immune to the
illness, Taylor of SAGE said. Society itself has a
blind spot when it comes to thinking about older
people contracting HIV. “We don’t tend to think of
older adults as sexual people and don’t tend to
think of them as using recreational drugs,” she
said.

The reality is that because people are living
longer, they are engaging in sex until a later age.
Viagra and other sexual enhancement drugs may
contribute to increased rates of sexual activity.
Also, physicians may not diagnose HIV infection in
older people, or inquire about their sexual habits
or drug use, or talk to them about risky behaviors.
Moreover, doctors may overlook early symptoms of HIV
as normal signs of aging.

Aging with HIV

The aging process tends to complicate the effects of
HIV. While older adults tend to adhere to drug
regimens better than younger people, the side
effects can be more severe, researcher Gebo said.
Renal failure is more likely to happen in the
elderly. Metabolism of the drugs is affected by
worsening kidney and liver function with aging, she
added.Complications from a variety of drugs also
appear to be a major problem. Medicines for
age-related conditions, such as heart disease,
depression, osteoporosis and diabetes, may interfere
with strong ARVs, which are used to treat HIV.

Dementia is another problem that older people with
HIV or AIDS are facing. While older people tend to
develop cognitive problems, ARVs may worsen them.
Moreover, many other health problems older people
face, such as osteoporosis, may progress faster in
people with HIV.

Other “hidden” illnesses, such as depression and
loneliness, are common in older adults with HIV.
Because of the stigma attached to HIV and AIDS, they
may feel they can’t tell their families and friends
about their illness. (“What will the people in
church think?”) Some may stop seeing their
grandchildren. While there are advocacy groups for
older adults, this cohort may shy away from joining
support groups. Depression, while a problem in
younger people, can lead to other health problems
and have more detrimental effects in older adults.

Financial Stress

Financial problems among this population also cannot
be overlooked, according to Gebo. Under Medicare
Part D, the government program that pays for
Medicare prescription drugs, there is a coverage
limit at which the government will stop paying for
drugs annually. That threshold is $2,250. When
Medicare recipients reach this level in drug costs,
they are responsible for the total cost of their
formulary expenses—until they reach $5,100 in total
spending. Many older adults with HIV must seek other
sources of funding, such as the Ryan White CARE Act,
that provide assistance to cover this gap.